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| 60例儿童肾综合征出血热患者的临床特点及重型高危影响因素 | |
| 引用本文： | 邓慧玲,张玉凤,刘宇阳,张瑜,王小燕,王军,袁娟,余鹏博. 60例儿童肾综合征出血热患者的临床特点及重型高危影响因素[J]. 中华实验和临床感染病杂志(电子版), 2018, 12(2): 150-154. DOI: 10.3877/cma.j.issn.1674-1358.2018.02.010 |
| 作者姓名： | 邓慧玲 张玉凤 刘宇阳 张瑜 王小燕 王军 袁娟 余鹏博 |
| 作者单位： | 1. 710003 西安市,西安市儿童医院感染二科2. 710003 西安市,陕西省疾病预防控制中心病毒所 |
| 基金项目： | 西安市科学技术局医疗卫生研究项目(No. 2016052SF/YX08); 陕西省科技统筹创新工程计划项目（重点产业创新链）(No. 2016KTZDSF02-04); 国家卫生和计划生育委员会公益性行业科研专项项目(No. 201502020) |
| 摘 要： | 目的分析儿童肾综合征出血热（HFRS）的临床特点及重型病例的危险因素,以指导该病的早识别、早诊断和早治疗。 方法选取200年1月至2016年12月西安市儿童医院临床诊断的儿童肾综合征出血热患儿共60例,分析其临床资料特点,并采用多因素Logistic回归分析明确重型病例的危险因素。 结果入组60例患儿临床表现均有发热,且消化道症状发生率高,肾综合征出血热的"三红"、"三痛"典型表现发生率并不高。实验室指标检查显示：入组患儿白蛋白异常、尿蛋白异常、降钙素原、白细胞及血小板计数异常率较高。多因素Logistic回归分析结果显示,PLT < 30 × 109/L（χ2 = 34.75、P < 0.001）、ALT > 500 U/L（χ2 = 27.30、P < 0.001）、PCT > 25 ng/ml（χ2 = 8.45、P = 0.02）、尿蛋白阳性（χ2 = 11.32、P < 0.001）和Scr > 250 μmol/L（χ2 = 7.89、P < 0.001）共5个影响因素的回归系数与病情严重程度相关,均具有统计学意义。 结论儿童肾综合征出血热临床表现不典型,无特异性表现,容易漏诊误诊,临床医师应该提高警惕;PLT、ALT、PCT、Scr显著异常及尿蛋白阳性是重型HFRS的危险因素。 |
| 关 键 词： | 肾综合征出血热 临床特点 重型病例 相关因素 |
| 收稿时间： | 2017-08-25 |
Clinical characteristics of 60 children with hemorrhagic fever complicated with renal syndrome and the risk factors of severe cases |
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| Huiling Deng,Yufeng Zhang,Yuyang Liu,Yu Zhang,Xiaoyan Wang,Jun Wang,Juan Yuan,Pengbo Yu. Clinical characteristics of 60 children with hemorrhagic fever complicated with renal syndrome and the risk factors of severe cases[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Version), 2018, 12(2): 150-154. DOI: 10.3877/cma.j.issn.1674-1358.2018.02.010 | |
| Authors: | Huiling Deng Yufeng Zhang Yuyang Liu Yu Zhang Xiaoyan Wang Jun Wang Juan Yuan Pengbo Yu |
| Affiliation: | 1. Department of Infectious Diseases, Xi’an Children’s Hospital, Xi’an 710003, China2. Institute of Virology, Shaanxi Provincial Center for Diseases Control and Prevention, Xi’an 710054, China |
| Abstract: | ObjectiveTo investigate the characteristics of clinical data of children with hemorrhagic fever complicated with renal syndrome and the risk factors of severe cases, and to guide the early identification, diagnosis and treatment of the disease. MethodsTotal of 60 patients with hemorrhagic fever complicated with renal syndrome in Xi’an Children’s Hospital from January 2010 to December 2010 were collected. The clinical data were analyzed and the risk factors of severe cases were analyzed by multivariate Logistic regression. ResultsThe 60 children all had fever, and the incidence rate of gastrointestinal symptoms was high, but the incidence of typical "three red" and "three pain" in children was not high. In laboratory tests, there were high percentage of abnormal albumin, urine protein, procalcitonin, white blood cells and platelet count in 60 cases. Multivariate Logistic regression analysis showed that PLT < 30 × 109/L (χ2 = 34.75, P < 0.001), ALT > 500 U/L (χ2 = 27.30, P < 0.001), PCT > 25 ng/ml (χ2 = 8.45, P = 0.02), urine protein (χ2 = 11.32, P < 0.001), Scr > 250 μmol/L (χ2 = 7.89, P < 0.001) were all associated with disease severity, with significant differences. ConclusionsThe clinical manifestations of children hemorrhagic fever complicated with renal syndrome were not typical and specific, so clinicians should be vigilant. PLT, ALT, PCT, Scr and urinary protein were the risk factors of severe HFRS. |
| Keywords: | Hemorrhagic fever with renal syndrome Clinical features Severe case Relevant factor |
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